This thesis presents a challenge to policy initiatives that presume that patient-centered care will reduce racial disparities in health. Data from the Medical Expenditure Panel Survey were used to test patient assessment of provider behavior defined as patient-centered care according to the National Health Disparities Report of the Agency for Healthcare Research and Quality of the Department of Health and Human Services. Results indicated patient-centered care improves self-rated health status, but blacks still report worse health status than whites experiencing comparable patient-centered care. Further, black-white differences in patient-centered care had no affect on health status. Rival theories of black-white differences in health, including social class and health literacy, provided better explanations of disparities than assessment of provider behaviors. These findings suggest that policies designed to financially incentivize patient-centered care practices by providers should be considered with caution. While patient-centered care is better quality care, financial incentives could have a negative effect on minority health if providers are deterred from practices that serve disproportionate numbers of poor and less literate patients and their families. Measurement of the concept of patient-centered care in future health disparities research was also discussed.

This thesis investigates the impact of fragmentation in the ownership of complementary patents or patent thickets on firms' market value. This question is motivated by the increase in the patent ownership fragmentation following the pro-patent shifts in the US since 1982. The first chapter uses panel data on patenting US manufacturing firms from 1979 to 1996, and estimates the impact of patent thickets on firms' market value. I find that patent thickets lower firms' market value, and firms with a large patent portfolio size experience a smaller negative effect from their thickets. Moreover, no systematic difference exists in the impact of patent thickets on firms' market value over time. The second chapter extends this analysis to account for the indirect impacts of patent thickets on firms' market value. These indirect effects arise through the effects of patent thickets on firms' R\&D and patenting activities. Using panel data on US manufacturing firms from 1979 to 1996, I estimate the impact of patent thickets on market value, R\&D, and patenting as well as the impacts of R\&D and patenting on market value. Employing these estimates, I determine the direct, indirect, and total impacts of patent thickets on market value. I find that patent thickets decrease firms' market value, while I hold the firms’ R\&D and patenting activities constant. I find no evidence of a change in R\&D due to patent thickets. However, there is evidence of defensive patenting (an increase in patenting attributed to thickets), which helps to reduce the direct negative impact of patent thickets on market value. The data sets used in Chapters 1 and 2 have a number of missing observations on regressors. The commonly used methods to manage missing observations are the listwise deletion (complete case) and the indicator methods. Studies on the statistical properties of these methods suggest a smaller bias using the listwise deletion method. Employing Monte Carlo simulations, Chapter 3 examines the properties of these methods, and finds that in some cases the listwise deletion estimates have larger biases than indicator estimates. This finding suggests that interpreting estimates arrived at with either approach requires caution.

In this thesis, the terms of trade changes in Turkey since 1970 are analyzed. In the 1970s, Turkey faced strong terms of trade declines mainly due to two oil price shocks. Rapid diversification of Turkish exports into manufactures was instrumental in avoiding further declines in its terms of trade in the 1980s. However, the slow pace of the diversification into more skill- and technology-intensive manufactures in Turkey combined with the fallacy of composition problem in low-tech, labourintensive manufactures may pose a real danger to the prices of its exports. To the extent that in the long-term, the changes in terms of trade of a country are determined by the level of technology embodied in its exports, the concentration of Turkish exports in low-tech, labour-intensive manufactures may highlight the need for upgrading exports and establishing backward- and forward-linkages between industries to escape from the trap of terms of trade deterioration in the long-term.

<p>For complex technical systems in the electricity and pulp and paper industries, maintenance management addresses how to exploit physical assets in the most profitably way. This is a difficult task that requires taking into consideration parameters of totally different natures – e.g. reliability data, operating costs, condition of technical systems, the environment and rules and regulation.</p><p>An incorrect estimate of a residual lifetime can result in a premature renewal with accompanying high capital costs. If, however, renewal is delayed, a breakdown may occur which can cause major damage to technical equipment and a loss of income due to outages. Because of the complexity of many technical systems, it can be hard to select adequate data to use when making decisions about renewal strategies. To cope with this, one approach is to use less detailed models that are operated by skilled analysts.</p><p>This work demonstrates the advantage of such an approach by proposing two methods applied in a joint methodology that has its origins in RCM. The methodology consists of Dynamic Lifetime Model (DLA) and the Condition Based Index (CBI). The DLA method copes with the financial risk associated with the point in time for when a renewal is carried out and the CBI method uses critical parameters to estimate the condition of a technical system. The two methods together create a quantitative connection between reliability, maintenance and financial risk. A case study based validation of the methodology was carried out at SCA Ortvikens paper mill on a refiner system and Forsmark nuclear power plant. Lessons learned from the case study showed that the methodology could be used to identify which components could cause costly breakdown. By using the methodology a manager gets a decision support tool for estimating short-term and long-term consequences of decisions regarding maintenance management in order to maximize utility of the system concerned</p>

Darbe atlikta teorinė darbo analizė ir iškelta hipotezė: inovatyvių metodų taikymas muzikinio ugdymo procese sudaro tinkamas prielaidas sutrikusio intelekto (SI) vaikų gebėjimų lavinimui ir savivertės plėtotei. Anketinės apklausos metodu atliktas tyrimas, kurio tikslas – nustatyti 8-10 metų SI mokinių inkliuzijos galimybes muzikinio ugdymo procese. Tyrime dalyvavo tėvai, auginantys sutrikusio intelekto vaikus, pedagogai ir mokiniai. Empirinėje dalyje nagrinėjamas SI mokinių muzikinis ugdymas namuose, pamokose ir popamokinėje veikloje. Atlikus tyrimą nustatyta, kad šiuo metu vykdoma neįgaliųjų integracija pilnai neišnaudoja galimybių, kurias švietimo kaitos dokumentų kontekste galėtų teikti SUP turinčių vaikų muzikinis ugdymas. Lieka dar daug neišnaudotų rezervų, kuriuos deramai pasitelkus būtų sudarytos prielaidos neįgaliesiems išreikšti save, didžiuotis, kad yra tokia sritis, kurioje ir jie gali save realizuoti. Ugdomojo proceso metu praktikoje buvo patvirtintas Asmeninės prasmės (APM, autorius A. Piličiauskas) ir Emocinio imitavimo (EIM, autorė L. Navickienė) metodų taikymo SI vaikų muzikinio ugdymo procese galimybės. Tyrimo metu įgyvendinta siekiamybė – skatinti ugdytinių tarpasmeninį bendravimą muzikinio ugdymo procese kaip svarbią jų asmenybės tapsmo prielaidą. Sėkmingas užsibrėžtų uždavinių įgyvendinimas leidžia teigti, kad tyrimo Įvade numatyta hipotezė pasitvirtino. / In this paper work the theoretical analysis has been carried out and the hypothesis has been raised: the application of innovative methods in the process of teaching music forms appropriate conditions for mentally disordered children to develop their skills and self value. The research has been carried out using the questionnaire to define the possibilities of inclusion in the process of teaching music of 8-10-year-old mentally disordered children. In this research have taken parents who raise mentally disordered children, also teachers and students. In the empirical part the author researches teaching mentally disordered children music at home, during the lessons and in after school activities. The research has shown, that the integration of disordered people has not used all the possibilities, which can be given by teaching music children with special needs in the context of educational changes. Still, a lot of reserves remain, which can be effectively used to give the possibility for disabled to express themselves and to be proud of having the sphere they can realize themselves. During the teaching process it has been practically proved the possibilities of application of Personal sense (author A.Piliciauskas) Emotional imitation (author L.Navickiene) methods in the process of teaching music mentally disordered children. During the research the aim has been achieved – to encourage the inter-relationship of students in the process of teaching music as an important... [to full text]

This thesis investigates the impact of fragmentation in the ownership of complementary patents or patent thickets on firms' market value. This question is motivated by the increase in the patent ownership fragmentation following the pro-patent shifts in the US since 1982. The first chapter uses panel data on patenting US manufacturing firms from 1979 to 1996, and estimates the impact of patent thickets on firms' market value. I find that patent thickets lower firms' market value, and firms with a large patent portfolio size experience a smaller negative effect from their thickets. Moreover, no systematic difference exists in the impact of patent thickets on firms' market value over time. The second chapter extends this analysis to account for the indirect impacts of patent thickets on firms' market value. These indirect effects arise through the effects of patent thickets on firms' R\&D and patenting activities. Using panel data on US manufacturing firms from 1979 to 1996, I estimate the impact of patent thickets on market value, R\&D, and patenting as well as the impacts of R\&D and patenting on market value. Employing these estimates, I determine the direct, indirect, and total impacts of patent thickets on market value. I find that patent thickets decrease firms' market value, while I hold the firms’ R\&D and patenting activities constant. I find no evidence of a change in R\&D due to patent thickets. However, there is evidence of defensive patenting (an increase in patenting attributed to thickets), which helps to reduce the direct negative impact of patent thickets on market value. The data sets used in Chapters 1 and 2 have a number of missing observations on regressors. The commonly used methods to manage missing observations are the listwise deletion (complete case) and the indicator methods. Studies on the statistical properties of these methods suggest a smaller bias using the listwise deletion method. Employing Monte Carlo simulations, Chapter 3 examines the properties of these methods, and finds that in some cases the listwise deletion estimates have larger biases than indicator estimates. This finding suggests that interpreting estimates arrived at with either approach requires caution.

Darbe sociokultūriniu požiūriu nagrinėjami skirtingų žanrų Tomo Venclovos tekstai, dėmesį kreipiant į subjekto identiteto raišką. “Aš naratyvą” suprantant kaip pasakojimą arba pasakojimus, padedančius individui ir kitiems refleksyviai suvokti jo tapatumą, lyginama subjekto tapatybės raiška eseistikoje ir publicistikoje bei poezijoje, gilinamasi, kaip kultūrinė bei literatūrinė “Aš tapatybė” perimama, integruojama ir veikia verčiamuose tekstuose. Subjekto identiteto raiška stebima laiko perspektyvoje to paties žanro tekstuose bei lyginama, kokie yra subjekto identitetų santykiai (panašumai, skirtumai, neatitikimai) skirtingo žanro tekstuose. Lyginant vertimo tekstą su originalais, išryškėja dvikryptis kultūrinio ir literatūrinio identiteto per���mimo procesas, leidžiantis įvardinti perimamus literatūrinius ir kultūrinius modelius. Subjekto identitetas eseistikoje labai stiprus ir aiškiai suvoktas. Jis nuosekliai palaikomas ir patvirtinamas, nepaisant jo prieštaringumo supančios aplinkos atžvilgiu. Poezijos subjekto „Aš naratyvas“ kinta laiko perspektyvoje, chronologiniu požiūriu vėlesniuose eilėraščiuose ryškus subjekto nebesugebėjimas įsitvirtinti laike ir erdvėje bei užmegzti ryšius su pasaulio objektais, kas yra pagrindinė tapatybės išlaikymo ir patvirtinimo sąlyga. Skirtingi „Aš naratyvai“ kuria prieštaringą, daugialypę, tačiau unikalią „Aš tapatybę“. / Work analyses different genres of T. Venclova‘s texts from sociocultural point of view, paying attention to the expression of subject’s identity. Understanding “narrative of the self” as narration or narrations, which helps individual and the rest reflexively realize its sameness, expression of subject’s identity is compared in essays and views on political issues, on societal and cultural developments, going deep into how cultural and literary “narrative of the self” getting intercepted, integrated and acts in translations of the texts. Expression of subjects identity is observed in prospect of the time in the texts of the same genre and it is compared what are the terms of the subject’s identities (likeness, difference, inadequacy) in the texts of the different genres. Translation of the text compared with originals, shows up bidirectional process of succession of cultural and literary identity, which lets designate successive literary and cultural models. Subject’s identity in essays is very strong and clearly seized. It’s sequaciously upholded and affirmed, despite its discrepancy from the point of surrounding environment. Subject’s of the poetry narrative of the self changes in prospect of the time, in chronologically later verses subject’s incapacity to make lodgement in time and expanse and to get in touch with world’s objects is clear, and that is the main condition of identity‘s sustention and acknowledgement. Divers narrative of the self composes controversial... [to full text]

<p>There is a growing interplay of competing realities facing the international community in the general areas of innovation, technological advancement and overall economic development. The highly industrialised wealthy nations, largely located on the Northern hemisphere are on the one hand undoubtedly at the forefront in global research, technology and infrastructure development. The developing and least developed countries on the other hand are mostly situated on the Southern hemisphere. They are not as wealthy or technologically advanced as their&nbsp / Northern counterparts, but are naturally endowed with unique variations of plant, animal and micro-organism species occurring in natural ecosystems, as well as the traditional knowledge on&nbsp / how to use these unique species. This knowledge has been adjudged to be responsible for the sustainable maintenance of the earth&rsquo / s biodiversity. Increasing exploitation of biodiversity,&nbsp / spurred on by the competing realities identified above, has left the earth in a present state of alarm with respect to the uncontrolled loss of biodiversity. The traditional knowledge of local&nbsp / peoples has significantly offered leads to research institutes from the North in developing major advancements in drugs, cosmetics and agriculture. Little or no compensation has however been seen to go back to the indigenous&nbsp / communities and countries that provide resources, and indicate various possibilities through their traditional knowledge to the use of such resources. Efforts by some biodiversity rich countries to&nbsp / ddress this trend through legislation developed in accordance with the principles of the Convention on Biological Diversity have been frustrated due to the inability to enforce their domestic laws outside their borders. Theft of genetic resources and its associated traditional knowledge&nbsp / from such countries has therefore remained a major challenge. Against this backdrop, and on the&nbsp / insistence of biodiversity-rich developing countries, an international regime on access and benefit sharing was negotiated and its final text adopted in 2010. This international regime is as&nbsp / contained in the Nagoya Protocol. This research sets out to examine whether the Nagoya Protocol offers a final solution to the protection of traditional knowledge associated with biodiversity in&nbsp / biodiverse countries. It further examines the importance of domestic legislation in achieving the objectives of the Protocol. The research has been tailored to African biodiverse countries, and&nbsp / seeks these answers within the context of Africa.<br /> &nbsp / </p>

Advances in numerical optimization have raised the possibility that efficient and novel aircraft configurations may be ``discovered'' by an algorithm. To begin exploring this possibility, a fast and robust set of tools for aerodynamic shape optimization is developed. Parameterization and mesh-movement are integrated to accommodate large changes in the geometry. This integrated approach uses a coarse B-spline control grid to represent the geometry and move the computational mesh; consequently, the mesh-movement algorithm is two to three orders faster than a node-based linear elasticity approach, without compromising mesh quality. Aerodynamic analysis is performed using a flow solver for the Euler equations. The governing equations are discretized using summation-by-parts finite-difference operators and simultaneous approximation terms, which permit nonsmooth mesh continuity at block interfaces. The discretization results in a set of nonlinear algebraic equations, which are solved using an efficient parallel Newton-Krylov-Schur strategy. A gradient-based optimization algorithm is adopted. The gradient is evaluated using adjoint variables for the flow and mesh equations in a sequential approach. The flow adjoint equations are solved using a novel variant of the Krylov solver GCROT. This variant of GCROT is flexible to take advantage of non-stationary preconditioners and is shown to outperform restarted flexible GMRES. The aerodynamic optimizer is applied to several studies of induced-drag minimization. An elliptical lift distribution is recovered by varying spanwise twist, thereby validating the algorithm. Planform optimization based on the Euler equations produces a nonelliptical lift distribution, in contrast with the predictions of lifting-line theory. A study of spanwise vertical shape optimization confirms that a winglet-up configuration is more efficient than a winglet-down configuration. A split-tip geometry is used to explore nonlinear wake-wing interactions: the optimized split-tip demonstrates a significant reduction in induced drag relative to a single-tip wing. Finally, the optimal spanwise loading for a box-wing configuration is investigated.

Three-dimensional design and three-dimensional CFD analysis of a compressor rotor stage are performed. The design methodology followed is based on a mean line analysis and a radial equilibrium phase. The radial equilibrium is established at a selected number of radii. NACA 65 series airfoils are selected and stacked according to the experimental data available. The CFD methodology applied is based on a three-dimensional, finite difference, compressible flow Euler solver that includes the source terms belonging to rotational motion. The accuracy of the solver is shown by making use of two different test cases. The CFD solution of the designed geometry predicts the static pressure rises and flow turning angles to a good degree of accuracy.